An Overview of Social Security Disability, P1 - What You Need to Know about the Social Security Disability Claims Process

Welcome to Season 4, Episode 13 of Winning Isn't Easy.  In this episode, we'll dive into the complicated topic of "An Overview of Social Security Disability, P1." 

Host Nancy L. Cavey, a seasoned attorney with extensive experience in disability claims, discusses an overview of, and answers general questions relating to, Social Security Disability. While the process of applying for Long-Term or Short-Term Disability might share similarities with the process of applying for Social Security Disability, the two are not the same and, in fact, have different procedures, different expectations, and different pitfalls to be aware of. It is important to understand these differences, especially as you might be expected to apply for both during the course of your disability. In this episode, host Nancy L. Cavey walks through some of the most important highlights of the Social Security Disability claims process.

In this episode, we'll cover the following topics:

1 - General Social Security Questions, P1

2 - General Social Security Questions, P2

3 - General Social Security Questions, P3

Whether you're a claimant, or simply seeking valuable insights into the disability claims landscape, this episode provides essential guidance to help you succeed in your journey. Don't miss it.


Resources Mentioned In This Episode:

LINK TO ROBBED OF YOUR PEACE OF MIND: https://caveylaw.com/get-free-reports/get-disability-book/

LINK TO THE DISABILITY INSURANCE CLAIM SURVIVAL GUIDE FOR PROFESSIONALS: https://caveylaw.com/get-free-reports/disability-insurance-claim-survival-guide-professionals/

FREE CONSULT LINK: https://caveylaw.com/contact-us/


Need Help Today?:

Need help with your Long-Term Disability or ERISA claim? Have questions? Please feel welcome to reach out to use for a FREE consultation. Just mention you listened to our podcast.

Review, like, and give us a thumbs up wherever you are listening to Winning Isn't Easy. We love to see your feedback about our podcast, and it helps us grow and improve.

Please remember that the content shared is for informational purposes only, and should not replace personalized legal advice or guidance from qualified professionals.

Transcript

Speaker A [00:00:11]:
 Hey, I'm Nancy Cavey, nationwide ERISA and individual disability attorney. Welcome to winning isn't easy before we get started today, I've got to give you a legal disclaimer. This podcast is not legal advice. The Florida Bar association says that I've got to tell you that, but nothing will prevent me from giving you an easy to understand overview of the disability insurance world, the games that disability carriers play, and what you need to know to get the disability benefits you deserve. Now, today I'm going to be taking on lots of questions I get about Social Security disability claims. Why am I going to talk about that? Well, many ERISA disability policies require that you apply for Social Security disability benefits. The reason, of course, is that the disability carrier wants to reduce your long term disability benefits by the receipt of Social Security disability benefits that you get and your family might get. They don't want to obviously pay the full benefit, and the policy provisions may give them the legal right to reduce your benefits.
 
 Speaker A [00:01:19]:
 But I think there are also some similarities between the proof that's used in a Social Security disability case and in an ERISA disability case and some of the same types of issues that arise in a Social Security disability case that will arise in an ERISA case. And since you've got to apply generally for these Social Security benefits, I want to talk about these issues and do some comparison and contrast. In the first segment, I'm going to be talking about something called medically determinable impairments, the roles that your doctor will play with listing of impairments. Explain what a listing of impairment is, talk further about your physician's role in this issue and just sort of COVID that whole listing issue and how it might draw, like draw some analogies, if you will, to an arrested disability case. The second series of questions that I get, I'm going to be talking about how the Social Security Administration finds somebody disabled at step five. Step five is an inability to do any other occupation in the national economy view of your age, education, skills, which sounds a little bit like any occupation standard in an ERISA case, a lot of the same issues. And we're going to be talking also in this segment about the impact of drug addiction or alcohol abuse. And we're also going to talk about the role of state agency doctors, who are much like the peer reviewed doctors that we will see in an erythidicity case.
 
 Speaker A [00:02:56]:
 In our last segment, we're going to talk about the use of consulting physicians, perhaps getting vocational evaluations, and of course, when you're going to get paid, and I'll talk again how that all relates to an ERISA disability claim. Got it. We've got a lot to cover today and I'm excited to answer these questions that I get. Let's take a break for a moment and get out some paper and a pen because there's lots of great information in today's episode.
 
 Speaker B [00:03:31]:
 Filing for Social Security disability or has your claim been denied already? Either way, you require a copy of your rights to Social Security disability benefits, which will cover everything you need to know about the Social Security disability claims process. Request your free copy of the book@kvlaw.com. Today.
 
 Speaker A [00:03:56]:
 Hey, welcome back to winning isn't easy. I'm a nationwide Social Security disability attorney. In addition to being a nationwide arrested disability attorney, I'm one of the few attorneys that do both. And I guess it's important that you understand the importance of having a lawyer who understands both of these and the nature of the proof that's required and how potentially we use the same proof in both cases. But let's start out with some basics. What is a medically determinable impairment for Social Security purposes and what does it matter? Now let's talk about the five step sequential evaluation test that the Social Security Administration uses. At step one, you have to determine that you have a medically determinable impairment, and they define that as a physical or mental impairment that results in anatomical, physiological, or psychological abnormalities, abnormalities that are demonstrated by medically, clinical and laboratory diagnostic techniques. So what does that mean in English? Well, it will depend on the nature of your condition.
 
 Speaker A [00:04:58]:
 So let's say you've got migraines or fibromyalgia. We all know that there's no gold standard test that can be used to definitively say that you have migraines or fibromyalgia. Diagnoses are normally based on certain symptoms that you report, and doctors will use a rule out methodology to rule out other medical conditions that could cause similar symptoms. Report of symptoms can constitute a basis for a diagnosis. Now, in the context of an ERISA case, many policies do require objective proof of a diagnosis and also objective evidence of disability. When we get to cases like migraines or fibromyalgia in the context of an ERISA case, we again are taking the same approach. And by that I mean we want to make sure that the medical records document rule out of other causes for migraines, which are again normally based on the history and fibromyalgia. Well, of course, there's the well known tenderpoint examination, but we want to make sure that the medical records are documenting that so that the disability carrier doesn't take the position that there is no impairment, medically determinable impairment, or objective basis for a diagnosis.
 
 Speaker A [00:06:15]:
 Now, let's say you have a medical condition like rheumatoid arthritis in the context of a Social Security case, much like a disability carrier, the Social Security Administration will expect that you have positive rheumatological studies or an explanation in your medical records as to why the doctor suspects that you have rheumatoid arthritis, notwithstanding the negative findings. And you're going to see the disability carriers expecting the same thing. Well, let's say you've got a medical condition like a herniated disc in your back. The Social Security Administration will expect to see diagnostic studies such as an MRI, physical findings consistent with that herniated disc, and symptoms that are consistent with the herniated disc. In other words, the Social Security Administration is looking for a diagnosis based on something more than a description of your symptoms. The same holds true in the context of an ERISA disability claim, and that particularly becomes true as their peer reviewed doctors review the medical records, cherry pick the records and say, look, there might be positive findings on an MRI, but the findings on physical examination aren't consistent or aren't consistent with the severity of the pain that you're reporting or the level of the dysfunction that your physician is reporting. So obviously there is this crossover, if you will, between what a medically determinable impairment is for Social Security purposes at step one and the issue of medically determinable impairments or objective diagnoses in the context of an ERISA disability case. And again, as an ERISA and Social Security attorney, I'm always looking for these issues because if I have this issue in the context of an ERISA case, I'm going to have this issue in the context of the Social Security claim because we generally try to work both of these claims hand in hand.
 
 Speaker A [00:08:13]:
 Now let's talk about the next topic. What role does your doctor play in the Social Security decision about whether you meet what's called a listing of impairments and are entitled to benefits? The five step sequential evaluation is step one asks whether or not you have a medically determinable impairment. The second question they ask is whether your impairment is expected to result in death or has already lasted or can be expected to last a continuous period of twelve months. At step three, the issue is, does your impairment meet or equal a listing? At step four, does your impairment prevent you from doing the simplest job you held in the 15 years before you became disabled? And number five, does your impairment prevent you from performing the lightest and simplest job you held in the 15 years before you became disabled? And at step five, does your impairment prevent you from performing other substantial gainful work in the national economy in view of your age, education, work experience and restrictions? Now, I will tell you, step one, step two, step four and five are normally what we see in the context of an arrested disability claim, just in different language. We generally don't see, of course, the question of whether or not a person meets or equals a listing, generally in the context of an ERISA disability claim. But where I do see it is if you have a Social Security decision and the claim is denied, in part because the judge doesn't think you have a medically determinable impairment or your condition does not prevent you from performing your past work or other work. Sometimes, though, I will see the disability carrier seize on the lack of a medical listing. To argue in the context of an ERISA case that the condition is not severe.
 
 Speaker A [00:10:15]:
 To me, that's absolutely legally incorrect and is a bastardized use of the listing of impairments. What is the listing of impairments? Well, let me take you back to high school biology. You remember studying body systems like the cardiovascular system, the pulmonary system, the skeletal system. You remember that, don't you? The Social Security Administration takes a body system approach. To determining whether you have a medically determinable impairment that meets or equals a listing. A medical listing is a set of medical findings. That are found in the Social Security disability blue book called listing of impairments. You could open up this listing of impairments and see the elements that you must establish in your medical records to meet a listing.
 
 Speaker A [00:11:03]:
 So let's say you have a herniated disc. You can go to section eleven of the listing of impairments, find herniated disc, and you will see the twelve to 15 criteria that you have to meet to establish that you meet or equal a listing. The problem in the context of a Social Security case is that doctors did not take a class in medical school to learn how to write a report for Social Security disability purposes. However, if you do meet a listing, and some of the times the medical condition is so severe and documented. That your benefits are automatically awarded at step three. Again, this does not happen in the context of an ERISA disability case, but disability carriers can sometimes attack the severity of the impairment, arguing that you didn't even meet a listing for Social Security purposes. What is your physician's role in deciding whether or not you have a medically determinable impairment that meets or equals a listing. Physicians are just as important in a Social Security case as they are in an arrested disability case.
 
 Speaker A [00:12:08]:
 And the Social Security Administration takes the position of whether or not you meet a listing to be one of medical fact and not medical opinion. But the Social Security Administration does regard the treating physician as a source of evidence and they will consider the opinion of a physician that a person meets the listing so long as the findings documented in the medical records coincide with the elements of the listing. Now doctors necessarily don't need any special expertise, but I generally ask them to fill out a form called a residual functional capacity form and I try to get it to the specialty doctor that's treating this particular condition. We lawyers have created many different residual functional capacity forms to use in our Social Security cases and I try to get the doctor to address the listing. Now, you can also be found disabled if your impairment is severe enough that it equals a listing. Again, that's very hard to do. I mentioned these residual functional capacity forms. I think they're very important in the context of an ERISA disability case.
 
 Speaker A [00:13:20]:
 The carrier has your doctor fill out these bland AP's forms, attending physician statement forms that don't ask the right questions on purpose because the carrier doesn't really want to know what your restrictions and limitations are. That's why when I represent somebody in their ERISA disability claim, I also want to handle their Social Security case. I want to make sure that the treating physician is completing these Social Security residual functional capacity questionnaires. They're based on specific medical diagnoses, so we have them for herniated disc pots, Ehlers Danlos, fibromyalgia. There must be at least 50 of them. I want to attach that completed residual functional capacity form to the disability carriers aP's form because I think the RFC forms are asking the right questions. I think it makes it harder for their liar for hire, peer reviewed doctors to cherry pick these RFC forms. All right, got it.
 
 Speaker A [00:14:17]:
 Let's take a break. Welcome back to winning isn't easy. In this session we're going to talk about general questions involving step five of the five step sequential evaluation, the use of state agency doctors, the impact of drug addiction, and those kinds of issues which I think also have some bearing on a Social Security disability claim. Now at step five, the Social Security Administration takes a two part approach to determining whether there's other work that you could potentially do in view of the mythical, hypothetical, not real world national economy, in view of your age, education, work experience and residual functional capacity. Where this analysis takes or starts, if you will, is to determine the level of the work activities that you can do despite your physical or mental impairment. So in other words, how long can you sit, stand, stoop, walk? Do you have to alternate sitting or standing? Do you have problems with bilateral manual dexterity? Would you be off task? If so, how much would you be absent from the workplace? Do you have psychiatric problems that would interfere with your ability to do simple, routine, repetitive tasks, accept criticism, deal with changes in the workplace, interact with the public, co workers, supervisors, or even stay on task? Now, at steps four and five, past work, other work, the Social Security Administration will determine the residual functional capacity. If they determine at step four that you can't do the simplest and lightest job you held in the 15 years before you became disabled, they're going to move on, most likely to step five. Now, remember the analogy here, that step four is much like the own occupation test, if you will.
 
 Speaker A [00:16:28]:
 In an EriSA disability claim, can you do the material and substantial duties of your occupation? There is a bit of a difference here in that Social Security is looking at jobs. The disability carrier is looking at occupations. Now, if the Social Security Administration gets to step five, there are two ways that they're going to analyze the claim. If you are over age 50, they're going to use the medical and vocational grids. And to be disabled to meet the grids, you have to have the right combination of your age, education, transferable skills, and functional capacities. If you're over 50, they're going to say, okay, what is your level of residual functional capacity? Is it medium, light, sedentary? And literally there is a chart that you can look down to see what the answer is. And as part of this, the Social Security Administration is going to look at your past work to determine whether it's unskilled, semi skilled, or skilled, because that's going to impact whether your skills transfer to other occupations in view of your residual functional capacity. This is very, very similar to what an ERISA disability carrier does in that they'll determine your residual functional capacity, determine what skills you have from your prior occupation, and whether or not they transfer.
 
 Speaker A [00:17:51]:
 Age is not a factor in an aristidissipway claim unless the policy or plan specifically says that it is. And there are many union plans that do require a favorable Social Security decision. And potentially in the context of that decision, your age is being considered. But for the most part, age is not a factor. Now, the use of the grids can be complicated, but if you don't quote unquote grid out, then the Social Security Administration is going to determine again whether you, whether you have skills potentially that would transfer to other work or depending on that particular issue, whether, because that goes to the grids, what is your residual functional capacity and are there other jobs that you could be plugged into that you don't want to do that doesn't pay a living wage? But again, what's key here in the similarities is that both Social Security and the disability carrier is determining the level of your residual functional capacity. Potentially they are trying to determine whether you, not you have, whether or not you have transferable skills. And in both instances the game is sedentary work. If you can do sedentary work in the context of your ERISA claim, most likely your claim is going to be denied.
 
 Speaker A [00:19:16]:
 In the context of a Social Security case, if you can do sedentary work, in part depending on your age, then you may win that case. The goal really is to prove in both instances, in my view, is that you can't do sedentary work based on limitations on sitting, the need to alternate sitting and standing, concentration and pace issues, bilateral manual dexterity issues and attendance issues. I'm going to talk about how we kind of create this scenario in both instances because the techniques are the same in my view, in both an ERISA disability and Social Security case. Okay, now let's talk about drug addiction and alcoholism. The Social Security regulations prohibit the payment of Social Security benefits if the person is disabled because of drug addiction or alcoholism. And the question often becomes if they were to stop using drugs or alcohol, would they still be disabled? And if, if that's the case, then potentially you entitled to your benefits. But if the drug addiction and alcoholism is material, no benefits are payable. Let me give you an example.
 
 Speaker A [00:20:31]:
 Let's say you have epilepsy that's caused by the excessive use of alcohol and your medical records establish that you are seen in the emergency room, you're being intoxicated and having seizures. Your medical records document the ongoing alcohol use. There's a clear opinion in the medical records that your physician, from your physician that the epilepsy is secondary to alcohol use. Well, would benefits be payable in the context of a Social Security case? If you stopped drinking and your seizures stopped, Social Security would find that the alcoholism was not material, even though alcohol abuse caused the seizures to begin with. On the other hand, if you continue to drink and your seizures continue, Social Security is going to find that your alcoholism is material and substantial and deny benefits. That same analysis holds true for drug addiction. Now, how does that apply or play out in the context of an ERISA case? I think that it's pretty similar because many disability policies or plans will have a limit on the how long they will pay for disability insurance benefits that are caused or contributed to because of alcoholism. And of course, they also have provisions in the policy that limit mental nervous conditions to just two years.
 
 Speaker A [00:21:54]:
 So many times the carrier will say, hey, this person's issues with drugs or medication or alcohol or the combination thereof really is the manifestation of a psychiatric condition. So we're gonna get you coming and going. You're limited to two years under the mental nervous policy limitation, and you're limited to two years under our alcohol or drug addiction issues. This also can, by the way, raise its head in the context of a preexisting condition clause. Depending on when you get the policy, there are preexisting condition clauses and there's a look back period. So let's say you got your policy today, and the policy says, look, if you got treatment for or diagnosed with even, there's a thought that you might have a drug issue or an addiction issue, and you got that in whatever the specific period of time is, be it 90 days, 120 days a year, the disability carrier will be looking in your medical records for a reason to deny a claim. And if they see that drug abuse or addiction is an issue and that's the cause of your current claim, they will deny that claim flat out on the basis that the condition, the disability is occasioned by a pre existing condition. So you can see that that kind of plays out in both worlds.
 
 Speaker A [00:23:20]:
 Why does a state agency Social Security doctor opinion is important. Why can it make or break your Social Security claim? When you apply for your Social Security disability benefits, the Social Security Administration is going to process the application at a local field office called disability determination services, and they're going to verify the non medical eligibility requirements. So, are you insured? Are you still working? Are you making more than you're allowed to make to legitimately claim disability benefits? But the field office will then, once they've satisfied those questions, send your case to the DDS office, who is responsible for developing the medical evidence and making the initial determination as to whether or not you're disabled. Now, DDS will normally get your medical records, not always, and not always the complete chart. If the evidence is unavailable or is insufficient for them to make a decision, DDS will consult with a state agency doctor. These doctors, who are not specialists, will render an opinion about the medical or psychological issues in your claim. They're going to address things like the existence and severity of your impairment, the existence and severity of your symptoms, whether your impairment meets a listing or equals a listing, what your residual functional capacities are notwithstanding your disability, whether the impairment meets the twelve month duration requirement, whether you fail to follow a prescribed treatment, and that's failure's impact on your disability. In the case of drug or alcohol addiction, where the addiction is material.
 
 Speaker A [00:24:57]:
 Now, that sounds very similar in some respects to what a peer reviewed doctor does in the context of a ERISA disability claim. Generally the carrier will have a nurse review it who is an expert in nothing. And sometimes they'll actually have a peer reviewed doctor who may not even be an expert in your area of disability, but they will be asked to address, you know, what's the diagnosis. Is there an objective basis of the diagnosis? Is there an objective basis for the restrictions limitations? What do you think the restrictions limitations are? Is the patient compliant? If they were compliant, will they still be disabled? If they're, if their treatment is being recommended, is it consistent with the complaints of pain or the level of disability or restrictions being claimed? And so we have liar for hire doctors, if you will, in both the Social Security disability world and in the ERISA disability world. So the analysis is one that flows in both of these cases. Now, why is this important? Well, if a Social Security claim was filed on or after March 27, 2017, there's no longer a treating physician rule. There's no deference, if you will, given to the treating physician. And much like in the ERISA world, the United States Supreme Court has said there's no treating physician rule.
 
 Speaker A [00:26:28]:
 Now, I will tell you, DDS, much like disability insurance carriers, will defer to the state agency or peer reviewed doctors at most stages of the case because it's just easier to deny a claim relying on your own experts then actually have to look at the file and make a reasoned decision. Now, of course, the difference in this is both in the context of a Social Security case and an ERISA case, the peer reviewed doctor never has a chance to examine you. They're just doing a paper review and they are relying on diagnostic studies. They're relying on the reports of the physicians regarding the findings and exam findings. Similarly, the same thing happens with the peer reviewed doctors, but sometimes they get more like information from the employer. They may get surveillance film, so they a copy of your statements, summaries of statements. So they're going to have a greater wealth of information. But the game is really the same.
 
 Speaker A [00:27:39]:
 Now, under the Social Security regulations, the DDS claims examiner is supposed to provide a written analysis of the persuasiveness of the medical opinions they rely on or in denying the claim. They're supposed to consider the supportability and consistency in addressing the treating physicians opinions and the state agency consultative opinions, but they're not required to explain how they considered other factors, including the relationship with opinion, patient specialization, familiarity with the evidence, whether there's new evidence that's been received after the medical source statement opinion that they've had an opportunity to look at. I will tell you, under the ERISA scenario, there are ERISA regulations which do require that the disability carrier explain how they arrived at the decision and how they differentiated between the treating physicians opinions and their peer review physicians and why they're accepting one over the other. But notwithstanding those regulations, disability carriers don't always do that or don't fully comply with the ERISA regulations, which can potentially be the basis for a claims appeal of a wrongfully denied or terminated claim. Now, when we get a Social Security disability claim and we get access to the electronic file, we want to review it from beginning to be and we specifically want to look at the state agency physicians opinion and the DDS analysis. Similarly, in the context of an ERISA case, we're doing the same thing. When we get the claims file, we're reading it cover to cover. We're looking at the adjusting notes to see what the claims examiner had to say, why they wanted the evaluation.
 
 Speaker A [00:29:27]:
 We look at the peer review report to see who they are. What's their reputation? What questions were they asked? Were they asked the right questions? What was their answer? Was there any reasoning in quotes behind this answer? How does it compare or contrast to what the treating physician had to say? So you can see that these games are played both in the context of an ERISA disability claim and in a Social Security claim. These are some of the reasons why a DDS medical consultant opinion can make or break your Social Security claim. And sometimes I have seen the ERISA disability carrier seize on DDS state consulting reports as a justification for their denial. And yes, they can get your Social Security file. All right, let's take a break before we go on to questions. Series of questions in number. Our third segment.
 
 Speaker B [00:30:23]:
 Professional with questions about your individual disability policy. You need the disability insurance claim survival guide for professionals. This book gives you a comprehensive understanding of your disability policy with tips and to dos regarding your disability application that will assist you in submitting a winning disability application. This is one you won't want to miss for the next 24 hours we are giving away free copies of the disability insurance claims survival guide for professionals. Order yours Today@disabilityclaimsforprofessionals.com. Dot.
 
 Speaker A [00:30:58]:
 Welcome back to winning isn't easy. I'm often asked, should I or my lawyer hire a consultative doctor in my Social Security disability claim? And I've asked that question in the context of an ERISA disability claim, and the answer is maybe obtaining, in my view, a favorable residual functional capacity form from your treating physician is preferable to hiring a one time consultative doctor. And the reason is that the Social Security Administration does not necessarily place a lot of weight on a one time consultative exam. But there are many times that I will recommend a consultative doctor, not only in the context of our Social Security case, but in an ERISA case, and the situations are pretty similar. I may want a consultative exam to cooperate and support the trading physician's conclusions. I may want that consultative doctor to clarify or address issues in difficult or complex medical conditions like pots, chronic fatigue, COVID complications, or rare disease. Now, because I represent people in both short and long term and Social Security case, I'm using these reports interchangeably. And I will take in the context of the ERISA case the questions that I see arise in the context of their peer review reports or imes.
 
 Speaker A [00:32:24]:
 And at the same time, I'm looking at the consultative medical exam reports of DDS people. I want my IME or my consultive physician to address the issues that arise in both cases because I want to kill two birds with 1 st. As I said, there is nothing in the Social Security regulations that allow a judge to give a consultive doctor's opinion less weight than a treating physician just because I may hire them. But there are some doctors who, I'm sorry, there's some judges who just aren't going to do that. They're going to give more weight to the state agency doctor because they're looking for a reason to justify a claims now. And the same reasoning holds true in the context of an ERISA disability claim. So the issue of whether or not you should get a consultative exam, an IME exam, or even a functional capacity evaluation will depend on the facts and the issues in both the Social Security claim and the ERISA claim. Should my Social Security attorney hire a vocational expert, perform my hearing, and as a matter of course, I would say to you no, unless we are using a vocational expert in the context of a short long term disability case, we are required under Social Security rules to provide the Social Security Administration and the judge all relevant documentation, including a vocational expert opinion, and I am legally obligated to do that regardless of whether it's good or bad.
 
 Speaker A [00:33:48]:
 Now, I will tell you when I do do it in the context of my ERISA cases and Social Security cases, I am generally at the own occupation stage. And so my ve is addressing the ability to do past work for their own occupation, and we're not really addressing other work, the other work standard in Social Security or other occupation standard. I have found that the vocational report can be helpful if the earlier Social Security denials have been predicated on a state agency finding that you've performed your past work in a manner that the Social Security Administration has misconstrued. And that also holds true in the context of an ERISA disability claim. While the Social Security standard is for the ve to consider the work that you've done in the 15 years before you became disabled. And by the way, there's a proposal to change it to five years. That's not the standard in the context of an ERISA case, they'll go back to jobs you held from college on. And so generally, I am just taking the ve report that I have in the context of my short or long term disability case and submitting it as part of my Social Security appeal.
 
 Speaker A [00:35:10]:
 And of course, remember, at step five, age is a factor, not necessarily a factor, in the ERISA disability cases. So if I get a case and I am dealing with both a Social Security claim and I'm at the any occupation stage in an ERISA claim, I'm asking the ve to address age and then to address it without age as a factor because I don't want the ERISA carrier to seize on a. Well, you know, the ve said that they were disabled in part because of their age, and that's not a factor in the context of the ErIsa case. So again, it depends on the facts of your case and where we're at in terms of a long term disability case. Are we at the ONOC stage or any occupation stage? I'm often asked. You were successful. We got a favorable Social Security decision. When on earth can I expect to be paid? You have probably waited forever to get that Social Security decision.
 
 Speaker A [00:36:10]:
 You've robbed Peter to pay Paul. You're in debt to your relatives. You're hanging on by a thread. Well, it normally takes about two months for the back benefits to be paid and the monthly benefits to begin in a Social Security case where there's no SSI application. If we've got SSI, which we generally don't. Well, if we do have SSi it's going to take longer because there's lots of math and I will tell you that the Social Security Administration will not talk to a Social Security lawyer about all these calculations. If you've been receiving workers comp, I will tell you that's going to take even longer because Social Security can offset workers comp, as can the disability carrier. So these offsets will go back and forth.
 
 Speaker A [00:36:50]:
 And that's important in the context of your ERISA case because you generally have an affirmative obligation to tell them that you've got the benefits. And of course then they're going to say you've been overpaid, pay us back and pay us back today. And by the way, we're denying our claim. If that happens, you certainly should be consulting with an experienced ERISA disability attorney. Generally, if you haven't been paid your Social Security benefits within 90 days of the day of the decision, you should contact your local office. If that doesn't work, you can try to contact the payment center. We'll call and leave messages and messages messages and never hear from them. And either way, you could be a longer wait that you want.
 
 Speaker A [00:37:31]:
 And if it's more than 90 days, contact your local congressman and have them intervene. I hope you have enjoyed this week's episode of Winning isn't easy. Please like our page, leave a review, share it with your family and friends, and please subscribe to this podcast. That way you'll get notified every time a new episode comes out. I hope you tune in next week for another insightful episode of Winning isn't easy.